The Power of Misperception

By Marilyn Allen, Editor-at-Large

Each month, I start this column with a blank sheet of paper and ask myself what I'm going to write about. Most of the time, the answer comes pretty quickly. There'll be a dinner or graduation ceremony I've attended recently, or I'll get a call from a former student asking about insurance reimbursement or some legal issue related to acupuncture, and voilà - I've got the subject for my article.

Note that I said most of the time. For those of you who don't write on a regular (or even semi-regular) basis, coming up with a new idea each month can be quite an experience. While I like order and structure, and I appreciate the idea of having a certain amount of time in which to write an article, I am not exactly what you would call a linear thinker. And I admit that there are times when the process of writing an article can become a bit overwhelming.

This past week looked like it was going to be one of those times. So much has been going on in the profession lately - a new executive director at the Acupuncture Alliance; a federally-funded study on acupuncture and bipolar disorder being conducted at the Southwestern Medical Center in Texas; a new acupuncture bill in Colorado; and a series of proposed laws that would change the way acupuncture and Oriental medicine is practiced in California - that it was hard for me to sit down and decide what to write about.

And then came the hypertension study and everything that has followed since. Haven't heard about it? You will.

On February 27, ABCNews.com ran a story titled "Acupuncture for the Heart: Study Examines Alternate Treatment for High Blood Pressure" by John McKenzie. The story began by mentioning a report that appeared in the Journal of the American Medical Association (JAMA), which stated that middle-aged Americans face a 90% chance of developing hypertension during their lifetime. Since hypertension can substantially increase the risk of life-threatening conditions like heart disease, kidney disease and stroke, and since millions Americans already have hypertension due to poor diet and lack of exercise, you can understand why the JAMA report would receive so much publicity from the mainstream press.

Mr. McKenzie's story then segued into the work of Dr. Randal Zusman, a medical doctor at Massachusetts General Hospital. For over a year, Dr. Zusman has been conducting a trial into the effectiveness of acupuncture in treating hypertension, with some admittedly remarkable results. In one portion of the story, McKenzie quotes Dr. Zusman as saying that a "substantial number" of patients in the trial have shown "significant reductions in blood pressure," and that as few as 12 acupuncture treatments delivered over a six-week period could produce a "cure" for hypertension.

I'm not sure how long Mr. McKenzie's story was online - my guess is 10 minutes, maybe 15 tops - before the phones at our office started ringing off the hook, with acupuncturists across the country asking how they could obtain an issue of JAMA and a copy of Dr. Zusman's study. It went on like this for several days before the calls started to die down.

What a story! I thought. We've got to write something about this. No, let's do one better: let's contact the AMA and have the study reprinted in Acupuncture Today so that the whole profession can get a copy. So I called Michael Devitt, AT's managing editor, asking him to call the AMA and clear space in the publication for a front-page, bold-headline, lead story about how acupuncture could cure hypertension.

"Are you sure about this?" Michael asked, thumbing through the issue of JAMA as I gave him the information. "I don't see it in here."

"I'm sure," I said.

"Okay. Let me make a couple of phone calls first," he said, and hung up.

Not 10 minutes later, my phone was ringing again. It was Michael, and he had some unfortunate news for me. It appeared that ABC News had gotten their story wrong. While the hypertension study had indeed appeared in JAMA, Dr. Zusman's study had not.

In fact, it hadn't appeared in any peer-reviewed medical journal.

In fact, it hadn't been submitted for publication.

In fact, it hasn't even been written.

"How do you know all this?" I asked him.

"Because I just got off the phone with Dr. Zusman's secretary," he said. "They're still working on it. The trial won't be complete for at least another month."

I learned two things that day. The first is that there may be no better person at getting information on the Internet - and getting it quickly - than Michael. I'm convinced that if he wasn't working for AT, he'd have no problem working as a codebreaker or gathering intelligence for the CIA.

I also learned an important lesson about the power of perception. A few days after the initial buzz died down, I obtained a copy of Mr. McKenzie's article. In the middle of the article was this sentence:

"The study is not yet complete, but Zusman is already enthusiastic."

There you have it, ladies and gentlemen. Mr. McKenzie's article clearly differentiated between Dr. Zusman's research and the JAMA article, but that didn't matter. People wanted to believe that acupuncture could cure hypertension, and so they incorporated two separate pieces of information into one pro-acupuncture story. They saw what they wanted to see, even though the evidence to the contrary was staring them in the face.

Seeing what we want to see, and not seeing what is really there, is an all-too-common occurrence in our field. Too often, we take the stance of "ignorance is bliss," overlooking the problems that really matter and instead taking the easy way out by focusing on issues that matter only to the immediate parties involved. Maybe when Dr. Zusman is finished finding a cure for hypertension, we can pool our resources and ask him to find a cure for our profession's continued misperceptions.

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